Arriving at what's best for elderly parents

Who makes the decisions for elderly parents?

Silvia Jansen/the Agency Collection photo

Silvia Jansen/the Agency Collection photo

Erin Peterson, Kiplinger Personal Finance

In 2007, John and Ginger Price knew that it was time to move John's mother, Mayna, from an assisted-living facility in South Carolina to a nursing home near their home in Seven Hills, Ohio. John's sister, who lived in South Carolina, could no longer shoulder the increasing caregiving responsibilities.

But Mayna was having none of it.

"She didn't want to move," says Ginger, 65. "If anything, she wanted us to move to South Carolina."

As tensions escalated, the Prices realized they might need outside help. They called John Bertschler, an elder mediator and co-owner of Northcoast Conflict Solutions. The family met with Bertschler in his Cleveland office to discuss possible solutions to the impasse.

Just 90 minutes after the meeting began, Mayna decided that she was ready to make the move to Ohio.

"Dr. Bertschler was able to approach the issue in a way that helped her understand that the move would be good for her," Ginger says. Mayna died in 2008, a year after moving into the nursing home.

As society ages, it's become more common for adult children to provide assistance to their elderly parents. But making sure that everyone, including the parent, agrees on a care plan can often be a challenge. A new type of go-between, known as an elder mediator, can guide squabbling siblings and elderly parents to solutions before conflicts tear a family apart.

A decision to see a mediator is usually prompted by disputes over at least one of three issues, says Carolyn Rosenblatt, an elder mediator in San Rafael, Calif.

"The trigger points tend to be how money will be spent, who will take care of the elder and whether the person who wants to do the caregiving is competent to do it," she says.

One common scenario, according to Patti Bertschler, co-owner with her husband of Northcoast Conflict Solutions, is when "an out-of-town sibling will swoop into town, upset with the level of care that the primary caregiver is providing, with little recognition of how backbreaking it can be to take care of mom or dad," she says. Or dad could be near death, and the kids can't agree on whether he should be kept alive by artificial means.

Mediators will guide the conversation to get input. And while mediators can share ideas that have worked for other families if there is a deadlock, says Patti Bertschler, "the parties themselves make the decision."

Elder mediators can help family members hammer out a process for solving problems, says Debbie Reinberg, a partner at Elderesolutions in Denver. For example, once the family decides mom will move, she says, "an elder mediator will help the family determine what kind of place she needs to move to, who's going to do the research on those places and how that information will be communicated so that decisions can be made."

How to find a family referee

You'll need to do research to find a good elder mediator. There's no national credentialing agency, but you can find lists of mediators at sites such as Eldercare Mediators (eldercaremediators.com), the National Care Planning Council (longtermcarelink.net) and mediate.com.

Once you have a short list of mediators in your area, ask about their credentials and their work with older adults.

"I would provide a one- or two-sentence description of what your dispute is about," says Carolyn Rosenblatt, an elder mediator in San Rafael, Calif. "If the mediator says 'Yes, I handle cases like that regularly,' that should give you confidence."

Mediators typically charge by the hour; hourly costs range from $100 to more than $300, depending on your location.

While minor disagreements may be wrapped up in less than two hours, some complicated cases can drag on for weeks. Ideally, all of the involved parties will agree to meet in person at the mediator's office. Large groups could appoint two or three family members to represent the group.